Ngeshwa, isifo sikashukela yisifo esihlala impilo yonke. Ngesikhathi sokulashwa, isiguli kufanele sifunde izindlela ezintsha njalo silawule indlela yaso yokuphila. Lesi sifo senzeka ngokushoda kwe-pancreatic hormone insulin (ifomu lokuncika le-insulin) noma ngokwephula isenzo salo (uhlobo olungathembekile lwe-insulin).
Zombili lezi zinhlobo ze-pathology zihlanganiswa ne-hyperglycemia (ukwanda kokuxineka kwe-glucose egazini). Ngokuhambisana, ukuphazamiseka kwe-metabolic kanye nezinguquko emsebenzini wezitho eziningi zezitho nezamasistimu kukhula. Ukwehlukaniswa kwalesi sifo ezinhlotsheni 1 no-2 akunagcini nje inani lomtholampilo elisetshenziselwe ukukhetha izidakamizwa ezidingekayo, kodwa futhi neye-etiological, ngoba izimbangela zalokhu kuhlukahluka kwalesi sifo kuhlukile.
Ukwelashwa kwesifo sikashukela kususelwa ekuqondisweni kwendlela yokudla nokudla, imisebenzi yokomzimba nokwelashwa kwezidakamizwa, kuya ngohlobo lwe-pathology kanye nendlela yokukhula kwayo. Lesi sihloko sidingida ukuthi imuphi umuthi osebenzayo ochwepheshe besifo sikashukela ongawunikeza ngalesi sigaba nokuthi yini izici zawo.
Izidakamizwa ezisetshenzisiwe
Imithi yesifo sikashukela i- mellitus (ngaphandle kwe-insulin) ihlukaniswe ngamaqembu amakhulu alandelayo:
- imali okuhloswe ngayo ukuthuthukisa ukuzwela kwamangqamuzana omzimba kwi-hormone yamanyikwe;
- izidakamizwa okuhloswe ngazo ukuvuselela ama-pancreas, okuholela ekwandeni kokuhlanganiswa kwe-insulin;
- Imithi yesizukulwane esisha - lokhu kufaka izinhlobo ezimbalwa zemithi enendlela ehlukile yokusebenza;
- umuthi wesifo sikashukela obambezela ukuhamba kweshukela kusuka emgudwini wesisu ungene egazini (Acarbose).
Ukubala ushukela okujwayelekile - inhloso yokwelashwa kwesifo sikashukela
Izivuseleli ze-pancreatic
Iqembu lokuqala labamele izidakamizwa ze-sulfa zesifo sikashukela. Le mithi ihloselwe ukuvusa umsebenzi wamaseli wokugcina we-insulin weziqithi zeLangerhans-Sobolev. Umphumela ukwanda kokuhlanganiswa kwezinto ezisebenza ngama-hormone.
Izinkomba zokuqokwa:
- iminyaka engaphezu kwengu-40, inqobo nje uma imithamo ebalulekile ye-insulin ingazange isetshenziswe ngaphambili;
- ukwehla kwesifo okulinganiselayo, lapho ukulungiswa komsoco kungaqedi amanani aphezulu kashukela.
Contraindication nokusetshenziswa kwezidakamizwa:
- uhlobo olumnene "lwesifo esimnandi";
- ukuba khona kwe-ketoacidosis, ukukhubazeka kwesifo sikashukela noma isimo esimnandi okwamanje nangaphambilini;
- amazinga aphezulu kashukela egazini, aphikelela ngesikhathi sokulungiswa kokudla;
- i-pathology yomongo wethambo, uhlelo lomchamo noma isibindi;
- ukukhulelwa nokukhipha umunyu.
Sulfonylureas
Iqembu elincane lezidakamizwa ze-sulfa. Indlela yesenzo sabo ukuvusa amaseli okugcina ama-insulin, ukukhulisa ukusebenza kwe-hormone, kanye nokunciphisa ukubopha kwe-insulin kuma-antibodies. Ama-Derivatives we-sulfonylureas ayakwazi ukukhulisa ukuzwela kwamangqamuzana ukuya ku-hormone futhi andise inani lama-insulin receptors ezicutshini. Izidakamizwa zimisa ukukhishwa ushukela kusuka esibindini kanye nokuthuthukiswa kwesimo se-ketoacidotic.
I-Diabeteson MV - isivuseleli esisebenzayo
Kubalulekile! Imithi yaleli qembu iyakwazi ukuvimbela isenzo se-glucagon ne-somatostatin, abangabaphikisi be-insulin.
Izidakamizwa (Glibenclamide, Tolbutamide, Diabeteson, Euglikon, Tolinase) zibekelwa ukwelashwa kwesifo sikashukela sohlobo 2 ngesisindo esijwayelekile noma esiphakeme sesiguli, uma ukwelashwa kokudla kungakwazi ukubhekana namazinga aphezulu we-glycemia futhi unesifo sesikhathi esingaphezu kweminyaka eyi-12-15.
Meglitinides
Lezi izidakamizwa ezinciphisa ushukela, umphumela wazo ohambisana nokukhuthaza ukukhiqizwa kwe-insulin. Ukusebenza kwezidakamizwa kuncike ezingeni le-glycemia. Izimpawu zokuphakama zoshukela wegazi kushukela, zona ziyasebenza kakhulu izidakamizwa. Abamele abasha - INovonorm, Starlix. Izindlela zinomphumela omfishane, ukuthathwa kwenhliziyo kufanele kwenzeke imizuzu emi-5 ngaphambi kokudla.
- I-Starlix ilungiselelo lethebhulethi elinokusebenza kwalo okuyi-nateglinide. Kubekelwe izinhlobo zesifo sikashukela sohlobo II ebusweni bokungasebenzi kahle kokudla kanye nokuzikhandla okwanele komzimba. I-Starlix ayinconywa kwifomu lesifo esincike ku-insulin, ukuthuthukiswa kombuso we-ketoacidotic, ngesikhathi sokukhulelwa nokuqunjelwa, ezinganeni ezingaphansi kweminyaka engu-18 ubudala.
- I-Novonorm umuthi womlomo osetshenziselwa ukwelapha isifo sikashukela sohlobo 2. Ingahlanganiswa ne-biguanides uma kwenzeka yehluleka kwe-monotherapy. Contraindication ifana ne-Starlix. Ukuqapha kufanele kuthathwe nge-pathology yesibindi, ukwehluleka kwezinso, ukusetshenziswa kabi kotshwala kanye nesimo esibucayi somzimba.
Izidakamizwa zesensitizer
Le yimithi yesenzo sayo okuhloswe ngaso ukuthuthukisa ukuzwela kwamangqamuzana kuyi-insulin esebenza nge-hormone esebenzayo. Lokhu kufaka amaqembu amabili izidakamizwa: i-biguanides ne-thiazolidinediones.
IBiguanides
Enye yamakilasi emithi yezidambisigciwane yomlomo. Abamele iqembu abalithinti inani le-insulin futhi abakwazi ukwenza ukungabi nalutho noma ukwehluleka okukhulu.
IMetformin yithebhulethi enhle kunazo zonke. Lapho ulisebenzisa, ukwehla kwesisindo somzimba kubhekwa ezigulini, kuyilapho umphumela ophikisayo kungenzeka ngokwelashwa nge-insulin analogues kanye nokuphuma kwe-sulfonylurea. I-Metformin iyakwazi ukulawula i-lipid metabolism, inciphisa inani lamafutha egazini.
I-Metformin ingummeleli ophumelelayo wama-Biguanides
Ngokusetshenziswa isikhathi eside, ungabona ukuba khona kokunambitheka kwensimbi emlonyeni, ukuhlaselwa isicanucanu nokuhlanza, isifo sohudo, ukuqhuma. Kwezinye izimo, i-lactic acidosis iyakhula - isimo esihambisana nokuqongelwa kwe-lactic acid egazini ngesilinganiso esibucayi futhi esidinga ukunakekelwa ngokushesha kwezokwelapha.
USiofor ungomunye wabamele abaziwayo bama-Biguanides. Isenzo sikaSiofor senziwa ngokunciphisa ukudonsela ushukela egazini, sandisa ukuzwela kwezicubu ukungena kwe-insulin futhi kuvimbele inqubo yokwakhiwa kweglucose ngesibindi. Ngaphezu kwalokho, umuthi unomphumela wehlise i-lipid futhi unomthelela omuhle ohlelweni lokuhlangana kwegazi. Kuboniswa ngesifo sohlobo 2 ngokuhambisana nokukhuluphala.
I-Thiazolidinediones
Izidakamizwa zisetshenziselwa ukufeza umphumela we-hypoglycemic ngenxa yokwehla kokumelana ne-insulin. Lawa amathuluzi akamuva. Izithako zemithi zesimanje zinganikela ngezinketho eziningana - i-Aktos, Avandia.
Izidakamizwa zithinta ukuzwela kwe-insulin ngenxa yomphumela we-lipid nezicubu zomzimba, kanye nesibindi, lapho kunokwanda kokusetshenziswa koshukela kanye nokuhamba kancane kokuqalwa kwaso. Ukuthatha umuthi kunganciphisa i-glycated hemoglobin ngo-1.5%.
Ama-Thiazolidinediones abekelwe lezo ziguli ezingakhuluphele kakhulu, ngoba ukusetshenziswa isikhathi eside kungaholela ekwandeni kwesisindo somzimba uma kuqhathaniswa nesizinda sokugcinwa kwamanzi emzimbeni.
I-Aktos - isidakamizwa esohlwini lwezidakamizwa ezikhethekile ezilwa nokulwa nezifo
I-Alpha Glucosidase Inhibitors
Abamele leli qembu balawula ukumunwa kwama-saccharides kusuka emathunjini kuya egazini nokuphuma kwawo emzimbeni. Uhlu lwezidakamizwa:
Uhlobo Olusha 2 Lwesifo Sikashukela- IGlucobai (Acarbose) isidakamizwa esidluliselwa ngomlomo okufanele sisetshenziswe ngokucophelela uma kwenzeka kulimala imishini, izifo ezithathelwanayo, ukungenelela kokuhlinzwa. Ayinqunyelwe ngesikhathi sokukhulelwa nokuqunjelwa, ezigulini ezincane, ngezifo ezingamahlalakhona zesisu namathumbu, ukwehluleka kanzima kwezinso.
- I-Miglitol - ithuthukisa ukusebenza kwama-Biguanides nama-sulfonylureas. Kuyinto engathandeki ukuhlanganisa ne-adsorbents yamathumbu, ama-antacid, amalungiselelo we-enzymatic. Sebenzisa ngemithi e-laxative ngokucophelela.
Izidakamizwa kumele ziphuzwe nokudla. Isenzo sisuselwa kumphumela we-hypoglycemic, kepha i-alpha-glucosidase inhibitors ayithinti isimo sokusebenza kwamaseli we-insulin-secretory of gland. Kuthunyelwe njengengxenye yokwelapha okuyinkimbinkimbi kwe- "isifo esimnandi".
Ama -retretins
Izidakamizwa zakamuva zokuhlanganisa, umphumela wazo ezihambisana nomphumela wokuhlanganiswa kwe-insulin, ngokuya ngama-indices we-glycemic. Izinto ezisebenzayo zibangela izinqubo ze-gluconeogenesis nokukhiqizwa kwama-hormone amaseli e-pancreatic. Ama-incretin angasetshenziswa njenge-mono- ne-polytherapy. Iqiniso elihle ukwehla kancane kancane kweshukela.
Uhlu lwezidakamizwa:
- U-Onglisa ngomuthi onento yakhe esebenzayo yi-sansagliptin. Umuthi ungahlanganiswa neMetformin, Aktos, Avandia, Glibenclamide. Ukwelashwa kanyekanye kwe-Onglisa ne-insulin analogues akufundiwe.
- I-Januvia yithebhulethi esekwe sansagliptin. Ikhulula ngokushesha okukhulu i-glycemia esiswini esingenalutho, ayithinti isisindo sesiguli.
- I-Vipidia - inhlanganisela yale ndlela namanye ama-hypoglycemic agents kanye nama-insulin analog evunyelwe.
I-Forsiga isidakamizwa sanamuhla esenziwe ngesiNgisi. Ososayensi bakhulelwa isenzo sayo ngendlela yokuthi umkhiqizo uvuselele ukuvuza kweshukela emzimbeni ngokwandisa umkhawulo wezinso weglucose. Umuthi ungasetshenziswa uhlangana nezinye izidakamizwa ezinciphisa ushukela kanye ne-insulin.
Ukugqugquzelwa kokuhlanganiswa kwe-insulin - "umsebenzi" wezidakamizwa ezikhuphukayo
Amanye ama-ejenti antidiabetes
Ososayensi baseChinese benze i-ejenti ye-hypoglycemic, Xiaoke Amaphilisi. Izilingo zomtholampilo zifakazele ikhono lomuthi ukunciphisa i-glucose, yenza isimo esijwayelekile somzimba wesiguli, ukubuyisela ukusebenza kwezinso, nokususa izimpawu zesifo.
I-Xiaoke iguqula amazinga e-cholesterol egazini, isusa "ngokweqile" emzimbeni, inyusa ithoni yemisipha, ithuthukisa ukuhanjiswa kwegazi kumanyikwe, iqinisa imithambo yegazi. Umuthi ukhipha izinto ezinobuthi kanye nokungcola emzimbeni.
Elinye ikhambi elinye yi-Diabenot. Izithako zayo ezisebenzayo izithako zemithi. UDiabotot wasungulwa ososayensi baseJalimane, abasanda kuvela emakethe yezokwelapha yaseRussia. Ithuluzi linemiphumela elandelayo emzimbeni womuntu:
- ukukhuthaza amaseli we-insulin secretory;
- ukuhlanzwa kwegazi kanye ne-lymph;
- ukwehla kwe-glycemia;
- ukukhuthaza amandla okuvikela;
- ukuvimbela izinkinga.
Ukukhetha kwemithi efanelekayo phakathi kwemithi eminingi enikezwayo kungukuphakanyiswa kwesazi esikhona
Izithako zokudla
Ezigabeni zokuqala zesifo sikashukela, ushukela ungashintshwa usebenzisa ukwelashwa kokudla kanye nokusetshenziswa kwezithako zokudla.
- I-insulin - isidakamizwa sivusa izinqubo ze-metabolic, isebenze ama-pancreas, sinciphisa ukumunca ushukela egazini.
- I-Tuoti - inempahla ye-hypoglycemic, iguqula izinqubo ze-metabolic.
- Glucberry - isidakamizwa esinciphisa isisindo somzimba. Isetshenziselwa ukuvikela ukuthuthukiswa kwezinkinga zesifo esikhona.
- IDialek iyimpuphu yokudla eyimpuphu, equkethe izinto ezilandelwayo ezivuselela izinqubo ze-metabolic.
Ukwelashwa kwesifo sohlobo 1
Uhlobo lwe-1 lwe-pathology yi-mellitus encike kwisifo sikashukela. Imithi edingekayo ezigulini ezinjalo ihlukaniswe ngamaqembu amabili ayinhloko: i-insulin nezidakamizwa ezengeziwe ezisusa izinkinga ezihlobene.
Kuya ngokuthi umphumela womjovo we-insulin uqhamuka ngokushesha kangakanani nokuthi ubude besikhathi sakho bunjani, izidalwa ezisebenza isikhathi esifushane, izidakamizwa zesikhathi esiphakathi nezidakamizwa ezinde zihlukaniswa. Inhlanganisela ye-insulin analog futhi nohlelo lokuphatha lusayinwe yi-endocrinologist ngawodwana. Udokotela ukhetha ukwelashwa ngokususelwa kuzinkomba ze-glycemia, isisindo somzimba wesiguli, ukuba khona kwezinkinga, kanye nesinxephezelo sesinxephezelo. I-insulin ifakwa isirinji noma ipampu.
Ukusetshenziswa kwephampu ye-insulin - amathuba okudla okuvamile kwe-hormone emzimbeni
Imithi eyengeziwe:
- Ama-inhibitors e-ACE - anciphise umfutho wegazi, anciphise umphumela onobuthi wezinye izidakamizwa emzimbeni;
- i-Cardio- kanye ne-vasotonic - yenza umsebenzi wesimo sezinhliziyo nemithambo yegazi kube ngokwejwayelekile;
- imali esekela isimo esisebenzayo sendawo yokugaya ukudla (ama-enzyme, ama-pro- kanye ne-prebiotic);
- ama-antidepressants, ama-anticonvulsants, ama-anesthetics endawo - ahlose ukuhlaziya i-analgesia uma kungenzeka kulimale izingxenye zangaphakathi zesistimu yezinzwa;
- ama-statins nama-fibrate - amaqembu anciphisa izinkomba ze-cholesterol "embi", ngakho-ke alwa nezinguquko ze-atherosulinotic emikhunjini;
- ama-anticoagulants - vikela ukwakheka kwezigaba zegazi.
Izidakamizwa ezithambile
Ngeshwa, ngaphandle kwemithi, ngaphezu kwe-95% yabantu abanesifo sikashukela abakwazi ukuthola isinxephezelo sezifo. Imithi eminingi enikezwayo ihlukaniswa njengezidakamizwa ezibizayo. Kubalulekile ukukhumbula ukuthi kunohlu lwemithi ekhethekile yesifo sikashukela. Lokhu kufaka izinhlobo eziningana ze-insulin, abamele ama-Biguanides, ama-alpha-glucosidase inhibitors, i-sulfonylureas.
I-ethyl alcohol, amasirinji okuphathela i-insulin angangezwa kulolu hlu. Bathola imishanguzo yokutholwa emakhemisi wombuso ngokombhalo okhishwe yi-endocrinologist. Imvamisa ngokushesha khipha inani elinjalo lezidakamizwa elalinele inyanga yokwelashwa.
Kubalulekile ukukhumbula ukuthi isifo sikashukela asisona isifo eselapheka “emjondolo”. Le ndlela ebabazekayo ingasheshe ibe yinkimbinkimbi ngokuphazamiseka kwezinso, izinzwa, nemithambo. Kungakho ukuhambisana nezeluleko zikadokotela oholayo nokufuna usizo ngesikhathi esifanele kuyisihluthulelo somphumela omuhle.
